BREAST CANCER CLINICAL CASE

Name: Mrs R / 44 yo
Hospital: Kasih Ibu Surakarta Hospital
Country: Indonesia
Diagnosis
Invasive Ductal Carcinoma Mammae (D) T2N1M1 ( Lung and
Bone)
Co-morbidities
Or any past history <insert text>
Disease overview at diagnosis
Patient with a lump at the right breast with the 3 cm in

greatest dimention , and two of lymphonode at the level II

Cancer has metastatic to the Right lung and the Vertebrae
and Pelvic Bone
Prior therapies for Advanced Breast Cancer
Chemotherapy with Cyclophosfamid and Doxorubicin for 3 times, one
time with Cyclophosfamid and epirubicin and Continuing with Brexel for 4
times
Radiotherapy got 7 times for bone and 25 times for breast
Next Chemotherapy with Zolenic, Herceptin and Xelloda
For lung metastatic patient got a chemotherapy with Gemsical,
Carboplatin 6 times and Next with Zolenic , Tykerb
Response to treatments
Partial respon but cancer has been Spreading to the lung and bone
Laboratory values and Radiological assessment :
Laboratory finding from IHC is Estrogen and Progesteron Reseptor is
negative, CeRb B and 2 Her-2 is positif
From Histlogical result after BCS is Ductal Carcinoma grade III and
mastectomy is Invasive Carcinoma grade III
Sitologi examination from TTNA is Suggest to Metastatic ductal Carcinoma
Histopatology sample from VATS is Metastatic ductal Carcinoma
Laboratory values and Radiological assessment :
Thorax X-Ray There is In homigenity at Right paracardial Suggest is
Pneumonic Metastatic
Thorax Computed Tomoghraphy There is Nodul Right Lung in medial lobe,
Osteoblastic at the 1st Lumbal and 8th-12th Thoracal Vertebrae
Pelvic X-Ray : Osteolitic Lesion at Ischium, Pubis and Illium bone at the
right side thats Metastatic bone appearance
From Bone Examination There are metastatic in 9th Thoracal Vertebrae ,
Right Sacroilliac joint and Right Ischium Bone
oncology Examination there is Nodul at the Right Lung
Question 1: disease assessment?
Question 2 :Treatment choice?
Conclusion